DESCRIPTION: The Texas Department of Mental Health and Mental Retardation (TDMHMR) is committed to incorporating empirically-supported interventions into a service array designed to meet the needs of the citizens of Texas with severe or persistent mental illness. As a part of this on-going effort, TDMHMR proposes to undergo a project designed to identify and implement an empirically-validated cognitive behavioral therapeutic approach for adults diagnosed with major depressive disorder. There is compelling research evidence that cognitive behavioral therapies are as effective as pharmacotherapy in improving depressive symptomatology and may be more effective in preventing relapse. The department has the long-range goal of identifying and implementing one or more validated psychotherapies throughout all community mental health centers in Texas. The current application has three primary aims: (1) to review empirically-validated, manualized, cognitive behavioral therapies for the treatment of major depression in adults and select a therapeutic approach that can best be transported into a community mental health system; (2) to create an implementation plan that includes a training module to maximize implementation and fidelity to the treatment model and addresses methods for reducing common barriers to implementation; and (3) to conduct a brief pilot study utilizing four to eight masters-level clinicians currently employed within community mental health clinics to provide the manualized treatment to consumers deemed appropriate for the service. Providers will undergo training and supervision by an expert consultant. Adults with major depression referred for counseling will be recruited for the study. Changes in symptom severity during treatment will be measured, as well as each therapists' level of competence with the selected therapeutic approach. This small pilot study will provide preliminary information on the feasibility of implementing this approach within community mental health clinics and provide guidance for the future planning of a more comprehensive implementation effort.